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Programmatic Challenges
Challenge: IPC methodologies tend to be too complex, manuals too wordy, activities too complicated, and too much emphasis placed on biomedical facts rather than the behavioral issues.
Solution: Focus content on behavior choices rather than facts about HIV and AIDS. Simplify manuals, guides, and support materials by including only the essential facts needed to support behavior change. Avoid wordiness and complicated formats that draw attention away from the information. Ensure they are user-friendly for the IPCs who are not literate. Before creating anything new, check existing programs for existing materials.
Challenge: Management obstacles.
Solution: Ensure that sufficient attention and resources are allocated to management, staffing, budgeting, and the creation of timelines. When insufficient attention is given to creating a supportive, structural environment, the entire program will suffer.
Challenge: Determining whether IPC should stand alone or be part of a larger project.
Solution: IPC can be complementary to a larger BCC intervention, or it can stand alone. When IPC programs stand alone, they typically are not sufficiently linked to health services. When they are part of a larger project, IPC is often perceived as a low-priority add-on. It is important to consider both circumstances.
Challenge: Ensuring that programmatic decisions are evidence based.
Solution: Allocate sufficient research resources at the beginning of the project. Create a research environment and an M&E structure that incorporates regular tracking of program activities and impact.
Challenge: Insufficient support & supervision.
Solution: To ensure that IPC agents are not left on their own and not doing their jobs, incorporate a supervision plan from the inception of the IPC program. Supervision mechanisms also provide an additional channel to obtain program feedback.
Challenge: Bringing pilot IPC programs to scale.
Solution: Small scale interventions can be so management intensive that scale-up seems impossible. Plan for scale-up during the pilot phase. Develop materials, M&E plans, management structure, and staff requirements with scale-up in mind.
Challenge: IPC discussions stray from the given topic or message.
Solution: Correct the assumption that the provision of facts will result in behavior change. During training provide IPCs with plenty of participatory activities [PDF] so that they do not rely on reciting facts about HIV/AIDS. Ensure that IPC expectations are clear from the start: their primary goal is not to educate through facts, but to educate AND promote behavior change by engaging target groups in discussions that are focused on increasing risk perception, improving skills and self-efficacy to make healthier behavioral choices, and addressing barriers to adopting healthy behaviors.
Challenge: Embarrassment talking about sensitive sexual issues.
Solution: Practice discussions in trainings using role plays. Develop support materials that will help facilitate sensitive discussions.
Challenge: Message degeneration.
Solution: Allow supervisors to correct IPCs when they get off topic. Develop support materials that help IPCs guide their discussions to focus on behavior change. Develop guidelines for each IPC session so that IPCs do not try to cover too many topics.
Challenge: Conducting participatory rather than didactic trainings.
Solution: Trainings should be focused on building IPCs’ skills to conduct interactive participatory discussions and activities with target group members rather than focusing solely on increasing HIV knowledge. This will help ensure that IPCs use more a reflective interactive approach to their field work.
Challenge: Developing support materials that encourage participation
Solution: Support materials such as flip charts, picture codes, cue and counseling cards that encourage target group participation are an essential tool for encouraging participation. They also make it easier for IPCs to raise sensitive topics. Focus on utilizing a variety of participatory techniques, games, and activities.
Challenge: Insufficient provision of support materials
Solution: Ensure that a sufficient portion of the budget is allocated to developing support materials. It is important to think in advance and plan so that enough materials are produced for the numbers of IPC staff.
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